Page 86 - Cover Letter and Evaluation for Dr. Herman Kensky

11/8/2017 Your Plan Results
Retail $24.30 Annual Drug Deductible: All Your Drugs on Enroll
Annual: $291.60 $405 Formulary :N/A
3 out of 5 stars
Mail Order Drug Copay/ Coinsurance: Drug Restrictions: N/A
Annual: N/A $1 - $28, 25% - 34%
MTM Program : Yes

Humana Preferred Rx Plan (PDP) (S5884-135-0)
Organization: Humana Insurance Company
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $25.40 Annual Drug Deductible: All Your Drugs on Enroll
Annual: $304.80 $405 Formulary :N/A
3.5 out of 5 stars
Mail Order Drug Copay/ Coinsurance: Drug Restrictions: N/A
Annual: N/A $0 - $1, 20% - 35%
MTM Program : Yes

AARP MedicareRx Walgreens (PDP) (S5921-392-0)
Organization: UnitedHealthcare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $26.70 Annual Drug Deductible: All Your Drugs on Enroll
Annual: $320.40 $405 Formulary :N/A
3.5 out of 5 stars
Mail Order Drug Copay/ Coinsurance: Drug Restrictions: N/A
Annual: N/A $0 - $31, 25% - 32%
MTM Program : Yes

WellCare Classic (PDP) (S4802-082-0)
Organization: WellCare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $26.70 Annual Drug Deductible: All Your Drugs on Enroll
Annual: $320.40 $405 Formulary :N/A
2.5 out of 5 stars
Mail Order Drug Copay/ Coinsurance: Drug Restrictions: N/A
Annual: N/A $0 - $31, 25% - 42%
MTM Program : Yes

Notes:
Your costs may be different depending on your Part B premium, any Part D penalty that may apply, and whether you qualify for
Extra Help from Medicare paying your drug costs.

Return to previous page

https://www.medicare.gov/find-a-plan/results/planresults/plan-list.aspx 3/3